Differential Diagnosis

Hip Dislocation

Hip dislocations are often caused by high-energy mechanisms and should be considered in the trauma patient presenting with hip pain or inability to ambulate. Since most patients with hip dislocations will appear to have a shortened leg with either internal or external rotation, they are often suspected prior to radiologic confirmation. Hip mobility and stability should be tested in trauma patients because of the possibility of more severe distracting injuries or if the patient is altered or unresponsive. Additionally, this diagnosis should be considered in all elderly patients presenting with hip pain or inability to ambulate after a ground-level fall. Due to the stability of the hip joint, hip dislocation is unlikely to be the cause of atraumatic hip pain, except in patients who have undergone recent total hip arthroplasty. (See Table 1.)